<?xml version="1.0" encoding="UTF-8" ?>
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" 
					  "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml"
	  xmlns:f="http://java.sun.com/jsf/core" 
	  xmlns:h="http://java.sun.com/jsf/html"
	  xmlns:ui="http://java.sun.com/jsf/facelets">
      
<h:head>
	<meta http-equiv="Content-Type" content="text/html; charset=UTF-8" />
	<title>Crisis Registration</title>
	<h:outputStylesheet name="view.css" library="css" />
	<h:outputScript name="view.js" library="js" />
	<h:outputScript name="calendar.js" library="js" />
</h:head>

<h:body id="main_body" >
	
	<h:graphicImage id="top" library="img" name="top.png"/>
	<div id="form_container">
	
		<h1><a>Crisis Registration</a></h1>
		
		<ui:include src="menu_inc.xhtml" />
		
		<h:form id="form_743394" class="appnitro" prependId="false">
			<div class="form_description">
				<h2>Crisis Registration</h2>
			</div>						
		
			<ul>
				
				<li id="li_1" >
					<h:outputLabel styleClass="description" for="element_1">Date </h:outputLabel>
					<span>
				 		<h:inputText id="element_1_3" name="date" styleClass="element text" size="10" maxlength="10" value="#{crisisC.date}" />
						<label for="element_1_3">MM/DD/YYYY</label>
					</span>
					<span id="calendar_1">
						<h:graphicImage id="cal_img_1" styleClass="datepicker" library="img" name="calendar.gif" alt="Pick a date."/>
					</span>
					<script type="text/javascript">
						Calendar.setup({
							inputField	 : "element_1_3",
							baseField    : "element_1",
							displayArea  : "calendar_1",
							button		 : "cal_img_1",
							ifFormat	 : "%B %e, %Y",
							onSelect	 : selectDate
						});
					</script>
				</li>		
				
				<li id="li_2" >
					<h:outputLabel styleClass="description" for="element_2">Intensity </h:outputLabel>
					<h:panelGroup>
						<h:selectOneRadio value="#{crisisC.intensity}" styleClass="element radio">
						    <f:selectItem id="element_2_1" itemLabel="Low" itemValue="1" />
						    <f:selectItem id="element_2_2" itemLabel="Medium" itemValue="2" />
						    <f:selectItem id="element_2_3" itemLabel="Strong" itemValue="3" />
						</h:selectOneRadio>		
					</h:panelGroup>
				</li>		
				
				<li id="li_3" >
					<h:outputLabel styleClass="description" for="element_3">Nausea </h:outputLabel>
					<h:panelGroup>
						<h:selectOneRadio value="#{crisisC.nausea}" styleClass="element radio">
							<f:selectItem id="element_3_1" itemLabel="Yes" itemValue="1" />
							<f:selectItem id="element_3_2" itemLabel="No" itemValue="2" />
						</h:selectOneRadio>
					</h:panelGroup>
				</li>		
				
				<li id="li_4" >
					<h:outputLabel styleClass="description" for="element_4">Time </h:outputLabel>
					<h:panelGroup layout="block">
						<h:selectOneMenu styleClass="element select small" id="element_4" value="#{crisisC.timer}">
							<f:selectItem itemLabel="" />
							<f:selectItem itemLabel="Morning" itemValue="0" />
							<f:selectItem itemLabel="Afternoon" itemValue="1" />
							<f:selectItem itemLabel="Evening" itemValue="2" />
						</h:selectOneMenu>						
					</h:panelGroup> 
				</li>
					
				<li class="buttons">
					<input type="hidden" name="form_id" value="743394" />
					    
					<input id="saveForm" class="button_text" type="submit" name="submit" value="Submit" />
				</li>
			</ul>
		</h:form>
			
		<div id="footer">
			<i>&copy;2013 All Rights Reserved.</i>
		</div>
	</div>
	<h:graphicImage id="bottom" library="img" name="bottom.png"/>
	
</h:body>
</html>